Dr Paul Wilson Brand

Notes

The son of missionary parents, Dr Brand spent his early years in the mountains of southwest India. At age nine, he went to London, England for his education and later completed medical school at London University, becoming a Fellow of the Royal College of Surgeons.

In India the Brands first came across deformities caused by leprosy. Very little was known about the true cause of these. It was generally believed that the hands and feet of infected people simply disintegrated or rotted away as a direct result of the disease. A senior colleague, Dr Robert Cochrane, challenged Paul Brand to use his skills as an orthopaedic surgeon to find out why people with leprosy developed deformed hands, and to try to find an effective treatment.

Dr Brand drew on experience he had gained during the Second World War with polio-paralyzed and war-injured hands. He undertook extensive research on damaged hands to test muscle strength and sensation. There were many obstacles to overcome – not the least being prejudice and resistance to using surgical skills on people with leprosy, and allowing them access to hospital care.

Paul Brand pioneered the idea that the loss of fingers and toes in leprosy was due entirely to infection and was thus preventable. Because leprosy attacks chiefly the nervous system, resultant tissue abuse occurs because the patient loses the warnings of pain – not because of inherent decay brought on by the disease.

As a skilled and inventive hand surgeon, he pioneered tendon transfer techniques with leprosy patients, and opened up a whole new world of disability prevention and rehabilitation for those affected by leprosy.

In the late 1940s, he became the first surgeon in the world to use reconstructive surgery to correct the deformities of leprosy in the hands and feet. Dr Margaret Brand devoted herself to researching methods to prevent blindness in persons with leprosy. Later, Dr Paul Brand was able to apply similar techniques to treat the limbs of persons with diabetes, as both diseases destroy pain sensation.

In 1953 the Brands joined the staff of The Leprosy Mission, and continued to develop their research and training work at Vellore and at the nearby Schieffelin Leprosy Research and Training Centre, Karigiri, newly founded and funded jointly by The Leprosy Mission and American Leprosy Missions. In 1964 after over 17 years in India, Paul Brand was appointed as The Leprosy Mission’s Director of Surgery and Rehabilitation.

Two years later they were seconded to the United States Public Health Service Hospital in Carville, Louisiana, which is the only leprosy hospital in the US and a world-famous centre for leprosy research. Here Paul was Director of the Rehabilitation Branch until his retirement in 1986 and continued to act as Medical Consultant to The Leprosy mission. From 1993 to 1999, Dr Brand was President of The Leprosy Mission International.

In retirement Dr Brand continued to contribute to leprosy work through his advisory role to The Leprosy Mission and to the World Health Organisation. He moved to Seattle and became Clinical Professor of Orthopoedics, Emeritus at the University of Washington.

Dr Brand has received many honours and awards in recognition for his outstanding achievements: he was Hunterian Professor of the Royal College of Surgeons in 1952; in 1960 he received the Albert Lasker Award for outstanding leadership and service in the field of rehabilitation; in 1961 he was honoured by Queen Elizabeth II with a CBE (Commander of the British Empire) for promotion of good relations between the Republic of India and Great Britain; in 1977 the Damian-Dutton Award for outstanding contributions in prevention of disabilities due to leprosy; and the US Surgeon General’s Medallion for his rehabilitation work in Carville, LA.

Dr Brand authored 100 scientific papers and seven books, including Clinical mechanics of the Hand, which is the premier handbook for hand surgeons, physiotherapists and other hand specialists. Co-author with Philip Yancey of three inspiring books, Fearfully and Wonderfully Made, In His Image, and Pain – The Gift Nobody Wants, Paul Brand is also the subject of Dorothy Clarke Wilson’s biography, Ten Fingers for God.

Dr Paul Brand died at the age of 89 years, from complications related to a subdural hematoma, on 8 July 2003 at Swedish Hospital, Seattle, Washington, USA.

Biographical details adapted from TLMI obituary for Dr Paul Brand, by Janet Walmsley, Director for Support and Development, 11 July 2003
There are also obituaries by Dr CK Job and Dr NH Antia in the Int J Lepr, 71.4 (2003):361-3.

Publications

100 scientific papers and seven books, including Clinical mechanics of the Hand, which is the premier handbook for hand surgeons, physiotherapists and other hand specialists.
Co-author with Philip Yancey of three inspiring books, Fearfully and Wonderfully Made, In His Image, and Pain – The Gift Nobody Wants.